Attacks go unreported

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Thousands of physical attacks by residents in aged care facilities go unreported because staff fear repercussions for the attackers, and a new watchdog is needed, industry sources say.

The Health Services Union, industry peak body the Victorian Association of Health and Extended Care, and the Health Services Commissioner all told The Age this week that residents who were violent were rarely reported the first few times they offended, especially if it was a staff member who was attacked.

Health Services Union state secretary Jeff Jackson said a membership survey three years ago found that violence in aged care was ranked second only to time constraints among his members' concerns. "It is not uncommon for us to get calls here about biting, spitting, scratching, lashing out or shoving," Jackson said. He said that members also sought advice on violence between residents.

Elder Abuse Prevention Association executive director Lillian Jeter said the problem was a hidden one but, based on comparisons with US figures, it was estimated that abuse and neglect could be affecting as many as 70,000 aged Victorians, with 5 per cent of that number in aged care facilities. The industry peak body's chief executive, Mary Barry, said aggression was most common among dementia patients, who could be frustrated and confused about encountering new surrounds or unfamiliar practices.

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Jill Duncan, training and resources co-ordinator at CASA House (Centre Against Sexual Assault), said there might be a tendency, as there was among teachers, to try to "manage the rights" of perpetrators and victims, when it was not a worker's place to judge. She said women who were assaulted should be counselled, but that past events could also emerge as a person aged. CASA had run courses on how to respond to disclosures from women about past violence, she said.

Barry said that as the population aged and more people with dementia entered homes for the elderly, the problems would only grow.

A report released this month by the Australian Institute of Health and Welfare, The Impact of Dementia on the Health and Aged Care Systems, found that, in 2002, 40 per cent of people in care accommodation had some form of dementia - equating to about 167,000 Australians.

Alzheimer's Australia national executive director Glenn Rees said not all those who were diagnosed with dementia displayed aggressive behaviour, but he believed the number of beds available specifically for people with dementia was about half the number needed.

Four years ago, the Royal Freemasons Homes of Victoria encountered a crisis when a survey revealed that staff members each had to deal with an average of 2.6 acts of aggression a week. The incidents ranged from violence to residents refusing food.

Freemasons training and development manager Michael Browning, spurred on by WorkCover incidents and wanting to retain staff, created a training program that last year won a health excellence award. The program looked at ways to approach a person with dementia and how they should be treated and counselled. "As a result, we have had a WorkCover incident-free year and our rate has dropped to 2.3 aggressive incidents," Browning said. Jeter called for a vulnerable adult protection service to match that of state-run child protection services. She said such a service operated in the US and served to protect the elderly, the disabled and those with a mental illness from neglect and abuse whether they lived in special care or at home.